Background/Purpose: There is a lack of studies about preconceptional paternal exposure to disease modified anti-rheumatic drugs (DMARDs) and the data of literature are controversial. The objectives are to study the difference in neonatal outcome between exposed fathers and non exposed fathers and to know information about preconceptional treatment management.

Methods: For this retrospective study, questionnaires have been sent to all the men followed in the department for rheumatic diseases (rheumatoid arthritis, spondyloarthritis or psoriatic arthritis). In this questionnaire there were questions about number of children, date of birth, treatment received during preconception, environmental factors of father and mother (tobacco, alcohol, other treatments and diseases and age) and information about preconceptional treatment management. Patients who received treatment during preconception period have been contacted to confirm their preconceptional treatment and neo-natal outcome, birth weight and term. For the neonatal outcome, two groups of patients were analyzed:  paternal exposed children and non exposed children.

Results: From 407 questionnaires sent, 200 answers were received.  Forty five men had a rheumatic disease diagnose at the preconceptional period. There were 77 births, 29 exposed children (11 to sulfasalazine, 7 to adalimumab, 6 to etanercept, 1 to infliximab, 1 to methotrexate and sulfasalazine, 1 to methotrexate and etanercept) and 48 non exposed children. There were 2 major birth defects in the exposed group (1 William and Beuren syndrome and 1 Turner syndrome) and no in the non exposed group, the difference was not  statistically significant (p = 0.138). There was no statistical difference between the two groups when birth weight is concern with 3.27 kg in the exposed group versus  3.07 kg in the non exposed group  (p = 0.09) and no difference concerning the gestational age:  41.6  weeks in the exposed group versus 39,6  in the non exposed.

On 200 patients, 52 patients were on DMARDs and under 45 years old and only 15 (28.8%) have discussed with the practitioner about paternal exposure and 32 (61.5%) estimated not having enough information on risk of paternal exposure.

Conclusion: In this study, even if there is no increased risk in neonatal outcome after paternal exposure to DMARDs, due to a weak birth rate in this population, fathers are left behind when pregnancy is concerned

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/neonatal-outcome-to-paternal-exposures-with-anti-rheumatic-therapy/